All ETDs from UAB

Advisory Committee Chair

Nancy Borkowski

Advisory Committee Members

James Byrd

Nathaniel Carroll

Larry Hearld

Dean Smith

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


The following essays examine the financial distress in acute care hospitals in the United States. The first essay examines the accuracy of prediction models of financial distress, the second explores the factors associated with financial distress and the third essay examines organizational response to financial distress. The first essay compares the predictive ability of three financial distress prediction models: modified Altman Z score (1993), Ohlson O score (1980) and Zmijewski (1984) to more accurately predict financial distress in U.S acute care hospitals. Building on the first essay, the second essay uses the most accurate predictive model to examine acute care hospitals’ environmental factors and organizational characteristics. The third essay examines the organizational response in the form of exit strategies (merger or closure) for financially distressed hospitals and examines the correlations among environmental factors and organizational characteristics that may be associated with the organization’s exit decision making.